Submission Form for South Taranaki's Electoral Representation Initial Proposal

Question Title

* 1. Contact Details

Name (who is the submission from?) *

Contact Person (if the name above is an organisation)

Postal Address *

Email Address *

Phone Number

Question Title

* 2. Contact Details

Name (who is the submission from?) *

Contact Person (if the name above is an organisation)

Postal Address *

Email Address *

Phone Number

Question Title

* 3. I wish to speak to the Mayor and Councillors about my submission on 30 July 2018?

Yes (you will be contacted to arrange a time)

No

Question Title

* 4. Do you support the Council's Initial Proposal?

Yes

Yes, but with changes (please say what changes you would like to see below)

No (please say why you don't support the initial proposal)

Further comments

Submissions are available to the public and the media. This includes your personal information. All submissions will be acknowledged. Submitters who wish to speak to their submission will be advised of a time on 30 July 2018 for their verbal hearing.

Remember, your submission must be received by 5pm, Monday 16 July 2018